MEDICARE: SHAMSA PERVEEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	M3689	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609823541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMSA PERVEEN MD

Provider Business Mailing Address
First Line	:	7035 HIGHWAY 6 S
Second Line	:	EXCEL CLINIC PA
City	:	HOUSTON
State	:	TX
Zip	:	77083-3305
Country	:	US
Telephone Number	:	281-776-9235
Fax Number	:	281-776-0404

Provider Business Practice Location Address
First Line	:	7035 HIGHWAY 6 S
Second Line	:	EXCEL CLINIC PA
City	:	HOUSTON
State	:	TX
Zip	:	77083-3305
Country	:	US
Telephone Number	:	281-776-9235
Fax Number	:	281-776-0404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	05/20/2015

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Directions to “ SHAMSA PERVEEN MD” Practice Location

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